Gender Differences in Routine Health Maintenance Examinations Before and During the COVID-19 Pandemic.

Purpose: Adolescent and young adult (AYA) males historically have lower healthcare utilization than their female peers.

Methods: Electronic health record data from an Adolescent/Young Adult Medicine outpatient practice were reviewed to assess gender differences in routine health maintenance examinations before and during the COVID-19 pandemic.

Results: Routine health maintenance examinations decreased for both males and females during the pandemic.

Ecological Momentary Assessment of Positive and Negative Affect and Associations with Blood Glucose in Teens with Type 1 Diabetes.

Background: Affect (i.e., emotions) can be associated with diabetes self-care and ambient glucose in teens with type 1 diabetes (T1D).

Transgender Adolescents' Experiences in Primary Care: A Qualitative Study.

Purpose: Transgender adults may avoid medical settings due to concerns about discrimination or past experiences of maltreatment. Emerging evidence shows improved outcomes and psychosocial functioning when transgender adolescents receive gender-affirming care, but little is known about transgender adolescents' experiences in primary care. The objective of this study was to learn about the experiences in primary care of transgender and gender nonconforming (TGN) adolescents and their recommendations for primary care practices and clinicians.

Acceptability of peer clinical observation by faculty members.

Background: Most doctors are not observed in the actual practice of medicine after they complete training. Direct observation and feedback are seen as invaluable in learning in most other professions, at formative stages of medical training and in other aspects of academic medicine, yet are not performed at the level of the independently practicing clinician. Creating an opportunity for faculty member development based on observation of clinical practice is needed for continued growth and competence as a clinician.

Teenage pregnancy prevention: the role of young men.

Purpose Of Review: Although teenage pregnancy is declining in many parts of the world, it remains associated with considerable social, health, and economic outcomes. Pregnancy prevention efforts focus primarily on young women, with minimal attention to young men. This review highlights recent literature pertaining to the role of young men in pregnancy prevention.

Screening, Brief Intervention, and Referral to Treatment.

Screening, Brief Intervention, and Referral to Treatment is a quick, effective technique with which to manage substance use in adolescents and young adults. Use of a validated measure for detecting substance use and abuse is significantly more effective than unvalidated tools or provider intuition. There are a variety of validated tools available to use in the adolescent/young adult population, and there are opportunities to increase the efficiency and scalability of screening by using computerized questionnaires.

Fractures Among Inpatients in a Pediatric Hospital.

Objective: Fractures occurring in hospitalized children may be an underrecognized preventable harm with implications for current and future bone health, but few data exist regarding the clinical characteristics of these pediatric patients. We describe the clinical characteristics of patients who sustained fractures during hospitalization over a 4.5-year period at a single tertiary care center.

Direct Versus Remote Clinical Observation: Assessing Learners' Milestones While Addressing Adolescent Patients' Needs.

Background: Direct clinical observation is an essential component of medical trainee assessment, particularly in the era of milestone-based competencies. However, the adolescent patient's perspective on this practice is missing from the literature. Quality health care is patient centered, yet we did not know if our educational practices align with this clinical goal.

Momentary assessment of social context and glucose monitoring adherence in adolescents with type 1 diabetes.

Purpose: To investigate the associations between momentary social context and glucose monitoring adherence in adolescents with type 1diabetes (T1D).

Methods: For 14 days, patients (14-18 years old, T1D duration >1 year) of a pediatric diabetes clinic carried handheld computers that prompted them to report their location, companionship, and attitudes toward companions at the times they usually checked their glucose, and again 30 minutes later to report whether they checked their glucose and, if not, why. Associations between social context factors and checking glucose (adherence) were analyzed using logistic generalized estimating equations and adjusted for age, sex, duration of T1D, and pump use.

Adherence challenges in the management of type 1 diabetes in adolescents: prevention and intervention.

Purpose Of Review: Despite the availability of effective therapies, adolescents with type 1 diabetes demonstrate poorer adherence to treatment regimens compared with other pediatric age groups. Nonadherence is tightly linked to suboptimal glycemic control, increasing morbidity, and risk for premature mortality. This article will review barriers to adherence and discuss interventions that have shown promise in improving outcomes for this population.

Outpatient prescribing errors and the impact of computerized prescribing.

Background: Medication errors are common among inpatients and many are preventable with computerized prescribing. Relatively little is known about outpatient prescribing errors or the impact of computerized prescribing in this setting.

Objective: To assess the rates, types, and severity of outpatient prescribing errors and understand the potential impact of computerized prescribing.

Patient-reported medication symptoms in primary care.

Background: Little is known about the prevalence and character of medication-related symptoms in primary care and their relationship to adverse drug events (ADEs) or about factors that affect patient-physician communication regarding medication symptoms.

Methods: The study included 661 patients who received prescriptions from physicians at 4 adult primary care practices. We interviewed patients 2 weeks and 3 months after the index visit, reviewed patients' medical records, and surveyed physicians whose patients identified medication-related symptoms.

Understanding of drug indications by ambulatory care patients.

Purpose: Patients' knowledge of the indications of their prescription medications was studied and those medications that were most likely to be taken without patients understanding the correct indication were identified.

Methods: Adult patients who received care at four primary care practices were surveyed. Patients were eligible to participate if they were over 18 years old and had received a prescription from a participating physician at a clinic visit.

Adverse drug events in ambulatory care.

Background: Adverse events related to drugs occur frequently among inpatients, and many of these events are preventable. However, few data are available on adverse drug events among outpatients. We conducted a study to determine the rates, types, severity, and preventability of such events among outpatients and to identify preventive strategies.